PHYSIOLOGICAL DYSREGULATION AS A PREDICTOR OF COGNITIVE DECLINE

Abstract Preclinical indicators of disease such as inflammation, cortisol and glucose dysregulation, and multisystem dysregulation (allostatic load) are related to individual differences in the level of cognitive functioning across adulthood. This study examined whether individual biological systems and allostatic load are related to differential patterns of change in cognitive functioning over 9 years. Data are from the Midlife in the United States (MIDUS) study second (biomarker and cognitive) and third waves (cognitive). The sample includes 863 men and women who ranged in age from 35 to 85 when the data were first collected. MIDUS biomarkers include a comprehensive range of biological and anthropometric measurements reflecting cardiovascular functioning, glucose metabolism, lipid metabolism, inflammation, HPA axis function, as well as sympathetic and parasympathetic nervous system function. Summary indices of dysregulation in each of these major systems as well as an overall index of multi-system dysregulation, or allostatic load were examined in relation to 9-year changes in episodic memory and executive functioning from the Brief Test of Adult Cognition by Telephone. Regression analyses, controlling for preexisting diseases and medications, showed that higher allostatic load was associated with decreased executive functioning over time for those who started out with higher cognitive performance at baseline, after adjusting for age, gender, race, English language, education, neurological conditions, medication use and smoking. Identifying biomarkers as antecedents of cognitive changes in midlife and old age, can potentially aid in the early detection of cognitive impairments and increase the possibilities for preventive interventions.

Preclinical indicators of disease such as inflammation, cortisol and glucose dysregulation, and multisystem dysregulation (allostatic load) are related to individual differences in the level of cognitive functioning across adulthood. This study examined whether individual biological systems and allostatic load are related to differential patterns of change in cognitive functioning over 9 years. Data are from the Midlife in the United States (MIDUS) study second (biomarker and cognitive) and third waves (cognitive). The sample includes 863 men and women who ranged in age from 35 to 85 when the data were first collected. MIDUS biomarkers include a comprehensive range of biological and anthropometric measurements reflecting cardiovascular functioning, glucose metabolism, lipid metabolism, inflammation, HPA axis function, as well as sympathetic and parasympathetic nervous system function. Summary indices of dysregulation in each of these major systems as well as an overall index of multi-system dysregulation, or allostatic load were examined in relation to 9-year changes in episodic memory and executive functioning from the Brief Test of Adult Cognition by Telephone. Regression analyses, controlling for preexisting diseases and medications, showed that higher allostatic load was associated with decreased executive functioning over time for those who started out with higher cognitive performance at baseline, after adjusting for age, gender, race, English language, education, neurological conditions, medication use and smoking. Identifying biomarkers as antecedents of cognitive changes in midlife and old age, can potentially aid in the early detection of cognitive impairments and increase the possibilities for preventive interventions.

USEFULNESS OF REVISED SIMPLIFIED SHORT-TERM COGNITIVE SCREENING TEST (STMT-R) IN ACUTELY ILL GERIATRIC PATIENTS
Hiroshi Yamamoto 1 , Kenichi Ogawa 1 , Yasushi Hisamatsu 1 , and Tatsuya Ishitake 2 , 1. Yamamoto Memorial Hospital, Imari-city, Saga, Japan, 2. Kurume University School of Medicine, Kurume-city, Fukuoka, Japan Background: Dementia can be a major cause of mortality and morbidity in geriatric patients. So, it would be essential to assess their mental state.Aims: We aim to appraise the impact of cognitive dysfunction on the long-term prognosis on STMT-R as a quicker and sensitive cognitive identification in acutely ill geriatric patients.
Methods: The inclusion criteria were to measure geriatric patients by STMT-R at admission, age≧50yo and being non-critical ill. Between October 2014 and September 2015, 836 were enrolled (52.4% female, mean age: 78.9 years). STMT-R≦4 was considered as cognitive dysfunction. Following the collection of clinical data, survival was subsequently measured for 7-8 years until January 2022. Cox's proportional hazards regression models were used to evaluate the hazard of death according to the dementia severity, with adjustment for potential covariates. Survival was estimated using Kaplan-Meier method.
Results: Among enrolled subjects, 144 were unable to complete the test due to severe dementia (ITG). 433 had cognitive dysfunction (STMT-R≦4; CDG) and 259 didn't have cognitive dysfunction (STMT-R>4; NCDG). The survival curves for death among three groups were significantly decreased in the CDG and ITG compared with the NCDG. The risks for mortality in the ITG and CDG are 3.92 (hazard ratio; 95% confidence interval:2.74-5.61, p< 0.001) and 1.82(1.33-2.51, p< 0.001) compared with the NCDG as reference.
Conclusion: 1) It was suggested that severity of cognitive dysfunction at admission has independently an impact on survival rate in acutely ill geriatric patients.2) STMT-R may also be useful for the future bedside or remote cognitive assessment.

ASSOCIATION BETWEEN SUBJECTIVE COGNITIVE DECLINE AND STRENGTH TRAINING IN US ADULTS AGED 45+ YEARS
Matthew Schroeder 1 , Molly Waring 2 , Nicole Fowler 3 , and Sherry Pagoto 2 , 1. Regenstrief Institute,Inc.,Indianapolis,Indiana,United States,2. University of Connecticut,Storrs,Connecticut,United States,3. Indiana University School of Medicine,Indianapolis,Indiana,United States Subjective cognitive decline (SCD) can be an early marker for Alzheimer's disease and related dementias. Data supports physical activity to delay cognitive impairment and to improve cognitive functioning. We examined strength training engagement by middle-aged and older US adults with and without SCD. We used data from 121, 059 participated aged 45 years or older from the 2019 Behavioral Risk Factor Surveillance System (BRFSS) from 31 states and Washington, D.C. SCD was assessed by asking participants if they had experienced confusion or memory loss during the past 12 months (yes/no). Participants reported how often they engaged in strength training (e.g., using weight machine, free weights) in the past month. We dichotomized strength training engagement as meeting physical activity recommendations (2+ times weekly) or not (< 2 times weekly). An adjusted logistic regression model, controlling for confounding variables, estimated the likelihood of strength training in relation to SCD. Analyses were weighted; results Innovation in Aging, 2022, Vol. 6, No. S1